 Welcome back to the channel, everybody. For those of you who are new around here, my name is Michael, AKA Dr. Cellini, and I'm a radiologist, self-specializing in interventional radiology in New York City. On today's video, we're going to be switching it up a little bit and talking about stocks, specifically focusing on a company in the radiology space, also known as Nanox Imaging, ticker symbol N-N-O-X. As you all know from prior videos, I am a sideline investor investing in stocks for pretty much my entire adult life with the occasional day trade on my days off. But what I really love doing is kind of deep diving into these healthcare stocks and seeing what the companies are all about and deciding if I want to invest in them or not. And as a physician, I feel like I can offer a unique perspective into analyzing these companies and hopefully you all could benefit from as well. And on that note, let's go ahead and get started on this deep dive into Nanox Imaging and make sure you stay to the end to see if I will be investing in the company myself. Let's go. Just a quick disclaimer here. I am just a physician. I am by no means a financial advisor and am not offering financial advice and am not telling you what to invest in. I just wanna make that clear. What you do with your money is your decision and yours alone. Don't take advice from me. I'm just a random guy on YouTube. Okay, so let's get started here. We're gonna break this video down in a few different sections here. First, we're gonna talk about what is Nanox Imaging, what products or services they offer, what I think about the company and will I be investing in the company? So let's go ahead and get started with what is Nanox Imaging? Now let's go ahead and pull up their website here. So nanox.vision. So the first thing we see here is x-rays reimagined. They have developed a digital x-ray source enabling a cost reduction of medical systems by orders of magnitude. So they are a global company planning mass deployment of imaging systems. Their goal is to drive early detection and preventive healthcare as a new standard of care, which is not really that new. It's basically the standard of all radiology. So there are not enough medical imaging systems in the world. According to World Health Organizations, two-third of the world's population have no access to medical imaging with many waiting weeks and months to access imaging. And this actually hits pretty close to home because as I was a resident in University of North Carolina doing my radiology residency, we actually had a joint program associated with Malawi which is a small country in Southeast Africa who only has access to one CT scanner in the entire country. A lot of my colleagues got the opportunity to go down there and read through these CT scans and they basically had a back room full of backlogged CT scans that no one has read for months and months because there were very few radiologists and only one scanner. It's not even remotely similar to how it is in the US where we just CT scan everybody that comes to the door. So I totally agree with this statement right here. They go on to say that early detection with imaging may potentially save millions of lives annually but obviously I totally agree. Now let's get into the products and technology that Nanox offers. For starters, here we have the Nanox Arc which is a digital x-ray source enabling significant reduction in medical imaging system cost and footprint. And they have the Nanox Initiative which is essentially a cloud-based platform to send images to medical professionals, hospitals and radiologists who will read them. So let's go ahead and break down these three items and we'll start with the x-ray tube because that's the most important. So Nanox is essentially the first company to digitalize the x-ray tube itself not just the image capturing or processing components. Now I'm not going to bore you too much with the x-ray physics involved with this company but I will try to simplify their technology because I think it's important to know. So conventional x-ray tubes use thermionic emission which is basically liberation of electrons by heating a surface metal to insane temperatures. Nanox however uses the cold cathode technology which refers to a cathode that is not heated to release electrons but instead extracts electrons on the metal by an external electric field. There are many benefits of this way of doing things including rapid acquisition because you don't have to wait for the cathode to get hot. Colder mechanism, normal cathodes operate around 2000 degrees Celsius or 3600 degrees Fahrenheit and these cathodes actually operate at room temperature. Also these cold cathodes last a lot longer than conventional x-ray tubes. They've somehow created a small chip to do all of this which is incredible. So to summarize all this, they basically figured out a way to make a cooler, more efficient x-ray tube at a fraction of the size of current technology. Now that we got this complicated x-ray technology out of the way and hopefully I've done a good job simplifying it for you, let's go ahead and talk about that machine, the Nanox Arc. So this Nanox Arc is supposed to be much smaller and inexpensive compared to other imaging devices. He uses several of the Nanox x-ray tubes that range in a curve above the table and it acquires the image via advanced imaging processing techniques such as tomosynthesis which has been around for quite some time. For reference we use it pretty much daily in breast imaging because if you've ever heard of a 3D mammogram that's essentially what this is. It creates a stackable, scrollable image through the breast and it gives you very high definition. So yes, this is a pretty sleek design and it's way smaller than most x-ray tubes which I guess means you could transport it to other countries and doesn't occupy that much space which is a good thing. So now let's get into the most important part of this video and the most important part to a radiologist which is how is the image quality? When I first heard about this company probably about five or six months ago I was really excited to see what kind of quality of imaging they offered but the problem was it wasn't until recently this past December where they finally released images that have been taken from this Nanox Arc machine. Before then we were just kind of left in the dark which is kind of strange but they did finally show some examples from their machine and I'll open this up right now and show you guys what I'm talking about. So it's actually kind of funny here. There's some historical significance behind this because this is the CEO of Nanox Imaging and he's taking a x-ray of his left hand which is iconic because Rankin who developed x-rays took a picture or x-ray of his wife's hand which I'll try to find a picture of here. It's gonna be very similar. She wore the rain during the x-ray. I think that's what he's trying to do here. But let's go ahead and look at the quality of the image so we don't bore you with this whole demonstration. So this looks pretty high-def and pretty detailed especially compared to normal radiographs which I'm used to looking at. So I think that's a good thing. The goal is to make an x-ray to as good or better. So if you do that, you're already on the right track. If you make it more efficient, smaller, et cetera that's the whole goal of this operation and I think they succeeded with it so far. The image on the right is a 2D x-ray. The image on the left is a 3D tomosynthesis x-ray. So you'll see in a moment here this is when they can actually scroll through and see fine detail within the bone. Very kind of similar to a CT but it doesn't focus on as much soft tissue detail as a CT would. So it's cool, but at the same time, I feel like it may be hard to detect fractures when you're scrolling through an x-ray. The goal of an x-ray is to see that 2D image and see a fracture. You may actually miss it if you're scrolling through. So I don't know how useful this is for x-rays of the hand because I don't know, we've been doing it this way for years. So at the end of this video before I show you other examples of the images, they did talk about this high res CT scan kind of of the chest here. They didn't say too much about it, but again, I'm not too impressed with this because performing a high res CT of the chest really isn't that hard given the x-ray technology. So we'll see. So here we have a commercial x-ray system versus the nanox source. They're pretty similar. I'd have to be able to actually window and level them to see how I can kind of get the contrast between the soft tissue and the bones. I never doubted the quality but the questions I have are with the company itself. I'm actually pretty impressed. The ability to completely change the x-ray tube which hasn't been changed in decades or ever for that matter may disrupt the whole medical imaging community. It's kind of like going from a large boxy tube TV to a sleek paper thin OLED TV. Imaging equipment has always been large, bulky, taking up a ton of space and for that reason is usually located in the basement which means the radiology department is located in the basement which means I have to read all my studies in the basement. As an interventional radiologist I'm used to working with x-ray equipment that is massive and takes up our entire room. The whole suite or angiosuite or room is designed around this x-ray machine. If they create a smaller, sleeker x-ray tube this may change a lot of things going forward. However we use fluoroscopy or live x-ray and I haven't seen these x-ray tubes handle that kind of work. Using live x-rays or fluoroscopy puts some serious strain on the machine so I'm curious to see what they do about that. So the x-ray tube is the most important part of this company but what are my thoughts on the arc and the cloud services? I think the arc is a great concept. I think it would be a way to get these smaller x-ray devices into countries and places around the world that normally wouldn't be able to house them. However, rather than developing an entire x-ray machine why don't they just license their x-ray technology into the big players of the x-ray field already like GE or Siemens? I feel like that might be the easier and more inexpensive option. These large medical imaging companies have already been building x-ray machines, MRIs, CTs for decades and decades. They have the housing, they have the established plants and engineers and they could likely incorporate these smaller and more efficient nanox imaging x-ray tubes into their x-ray platforms. But if they wanna be a true disruptor in this medical imaging space I guess they have to approach it head on and fight these bigger larger tried and true companies. I'm not sure I would approach it this way though. And lastly, let's talk about the cloud-based imaging service which I'm least excited about. The reason I'm not that excited is because this already exists. Radiologists are already reading off-site and utilizing cloud-based imaging services to get their images. Heck, I don't even know a radiologist that doesn't read from an outside source or use a cloud-based service. There are even tele-radiology jobs that are halfway across the country say on the West Coast, reading for hospitals on the East Coast. I even know of some radiologists who live in Hawaii and read for stuff on the mainland. This technology has been around for a long time now and works pretty well. So let's talk about what we've all been waiting for and that is, am I going to invest in this company? The shorter answer is, I think so, but only as a speculative investment. I think the nanox-cold cathode x-ray technology could address something that's often overlooked in medical imaging, space. Furthermore, this x-ray technology could be further implemented into something like a CT scanner which also uses x-rays. I think once they get FDA approval which is hopefully soon, the stock will obviously shoot up, but I think they have some hurdles to kind of crossover before this company makes it. They are going to get some big players in the medical imaging space that have been in the game for a very long time. For that reason, I think focusing on the x-ray tube technology might be the play here. So I actually may be looking into starting a small, long-term play for nanox imaging, ticker and an OX. So I hope you all enjoyed this video. If you want me to do more breakdowns like this, let me know in the comments below. If you're interested in a medical healthcare, pharma, biotech stock, let me know in the comments below. And if you want me to do a deep dive on it, also let me know as well. This is actually pretty fun for me because I like investing and I like investing in medical stocks. As always, smash that subscribe button, follow me on Instagram if you don't already. Otherwise, I'll see you all on the next video. Bye.